A comprehensive review of evolution of advanced follicular unit excision systems.

Initially, the application of the follicular unit excision (FUE) technique for hair transplantation faced a challenge due to a significant occurrence of hair follicle damage. However, advancements in techniques, punch designs, and tools have successfully addressed this issue. The integration of motorized equipment featuring rotation, roto-oscillation, oscillation, vibration, suction, and hydration has significantly improved the successful harvesting of grafts. More recently, the adoption of robotic technology for both graft extraction and incision is becoming increasingly common in FUE procedure. Given the wide range of available devices and technologies, hair transplant surgeons may find it challenging to select the most suitable option for their specific practices. The advancements in techniques, punch shapes, and motorized devices have played a key role in reducing the rate of follicle damage and increasing the speed of FUE procedures. It is crucial for hair restoration surgeons to stay informed about the various accessible devices and understand how these tools can be customized to suit the unique hair and skin characteristics of each patient.